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Final Exam Advanced Pathophysiology
Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction? A) lysosomes B) peroxisomes C) ribosomes D) oxyhydrosomes - Ans: B- peroxisomes What is a consequence of plasma membrane damage to the mitochondria? A) enzymatic digestion halts deoxyribonucleic acid (DNA) synthese B) influx of calcium ions halts adenosine triphosphate (ATP) production C) edema from an influx in sodium causes a reduction in ATP production D) potassium shifts out of the mitochondria, which destroys the infrastructure - Ans: B- influx of calcium ions halts adenosine triphosphate (ATP) production Which statement is a description of one of the characteristics of apoptosis? A) apoptosis involves programmed cell death of scattered singel cells B) apoptosis is characterized by the swelling of the nucleus and the cytoplasm C) apoptosis involves unpredictable patterns of cell death D) apoptosis results in benign malignancies - Ans: A- apoptosis involves programmed cell death of scattered singel cells During cell injury caused by hypoxia, sodium and water move into the cell because: A) during cell injury cause by hypoxia, sodium and water move into the cell because: B) the pump that transports sodium out of the cell cannot function because of a decrease in adenosine triphosphate (ATP) levels C) the osmotic pressure is increased, which pulls additional sodium across the cell membrane D) oxygen is not available to bind with sodium to maintain it outside of the cell - Ans: C- the osmotic pressure is increased, which pulls additional sodium across the cell membrane What is an effect of ionizing radiation exposure? A) respiratory distress B) sun intolerance C) deoxyribonucleic acid (DNA) abberations D) death - Ans: C- deoxyribonucleic acid (DNA) abberations Obesity creates a greater risk for dehydration in people because:
A) adipose cells contain little water because fat is water repelling B) the metabolic rates of obese adults are slower than those of lean adults C) the rates of urine output of obese adults are higher than thos of lean adults D) the thirst receptors of the hypothalamus do not function effectively - Ans: A- adipose cells contain little water because fat is water repelling In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces? A) oncotic pressure B) buffering C) net filtration D) hydrostatic pressure - Ans: D- hydrostatic pressure Venous obstruction is a cause of edema because of an increase in which pressure? A) capillary hydrostatic B) interstitial hydrostatic C) capillary oncotic D) interstitial oncotic - Ans: A- capillary hydrostatic At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because: A) the interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure B) the capillary hydrostatic pressure is higher than then capillary oncotic pressure C) the interstitial oncotic pressure is higher than the interstitial hydrostatic pressure D) the capillary oncotic pressure is lower than the interstitial hydrostatic pressure - Ans: B- the capillary hydrostatic pressure is higher than then capillary oncotic pressure It is true that natriuretic peptides: A) decrease blood pressure and increase sodium and water excretion B) increase blood pressure and decrease sodium and water excretion C) increase the heart rate and decrease potassium excretion D) decrease the heart rate and increase the potassium excretion - Ans: A- decrease blood pressure and increase sodium and water excretion What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma in hypernatremia? A) high sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink B) high sodium in the brain cells pulls water out of the blood vessels into the brain cells, causing them to swell
The functions of the major histocompatibility complex (MHC) and CD1 molecules are alike because both: A) are antigen-presenting molecules B) bind antigens to antibodies C) secrete interleukins (ILs) during the immune process D) are capable of activating cytotoxic T lymphocytes - Ans: A- are antigen-presenting molecules The B-cell receptor (BCR) complex functions uniquely by: A) communicating information about the anitgen to the helper T (Th) cell B) secreting chemical signals to help cells communicate C) recognizing the anitgen on the surface of the B lymphocyte D) communicating information about the antigen to the cell nucleus - Ans: D- communicating information about the antigen to the cell nucleus The generation of clonal diversity includes a process that: A) involves antigens that selet lymphocytes with compatible receptors B) allows the differentiation of cells into antibody-secreting plasma cells or mature T cells C) takes place in the primary (central) lymphoid organs D) causes antigens to expand and diversify their population - Ans: C- takes place in the primary (central) lymphoid organs Vacinations are able to provide protection against certain microorganisms because of the: A) strong response from immunoglobulin M (IgM) B) level of protection provided by immunoglobulin G (IgG) C) memory cells for immunoglobulin E (IgE) D) rapid response from immunoglobulin A (IgA) - Ans: B- level of protection provided by immunoglobulin G (IgG) What is the mechanism that results in type II hypersensitivity reactions? A) antibodies coat mast cells by binding to receptors that signal its degranulation, followed by a discharge of preformed mediators B) antibodies bind to soluble antigens that were released into body fluids, and the immune complexes are then deposited in the tissues C) cytotoxic T (Tc) lymphocytes or lymphokine-producting helper T 1 (Th1) cells directly attack and destroy cellular targets D) antibodies bind to the anitgens on the cell surface - Ans: D- antibodies bind to the antigens on the cell surface When soluble antigens from infectious agents enter circulation, tissue damage is a result of: A) complement-mediated cell lysis B) phagocytosis by macrophages C) phagocytosis in the spleen
D) neutrophil granules and toxic oxygen products - Ans: D- neutrophil granules and toxic oxygen products Considering the hypothalamus, a fever is produced by: A) endogenous pyrogen acting directly on the hypothalamus B) exogenous pyrogens acting directly on the hypothalamus C) immune complexes acting indirectly on the hypothalamus D) cytokines acting indirectly on the hypothalamus - Ans: A- endogenous pyrogen acting directly on the hypothalamus Vaccines against viruses are created from: A) killed organisms or extracts of antigens B) live organisms weakened to produced antigens C) purified toxins that have been chemically detoxified D) recombinant pathogenic protein - Ans: B- live organisms weakened to produced antigens Carcinoma in situ is characterized by which change? A) cells have broken through the local basement membrane B) cell have invaded immediate surrounding tissue C) cell remain localized in the glandular or squamous cells D) cellular and tissue alterations indicate dysplasia - Ans: C- cells remain localized in the glandular and squamous cells Two "hits" are required to inactivate tumor-suppressor genes because: A) each allele must be altered and each person has two copies, or alleles, of each gene, one from each parent B) the first hit stops tissue growth and the second hit is needed to cause abnormal tissue growth C) tumor-suppressor genes are larger than proto-oncogenes, requiring two hits to effect carcinogenesis D) the first hit is insufficient to cause enough damage to cause a mutation - Ans: A- each allele must be altered and each person has two copies, or alleles, of each gene, one from each parent What is the skin-related health risk induced by some types of chemotherapy? A) infection B) ultraviolet damage C) pain D) erythema - Ans: A- infection When a child is diagnosed with cancer, which intervention has the greatest influence on the child's mortality rate? A) age at the time of diagnosis
Graves disease develops from: A) a viral infection of the thyroid gland that causes overproduction of thyroid hormone B) an autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue C) thyroid-stimulating immunoglobulin, which causes overproduction of thyroid hormones D) ingestion of goitrogenes, which inhibits the synthesis of the thyroid hormones, causing goiter - Ans: D- ingestion of goitrogenes, which inhibits the synthesis of the thyroid hormones, causing goiter Pathologic changes associated with Graves disease include: A) high levels of circulating thyroid-stimulating immunoglobulins B) diminished levels of TRH C) high levels of TSH D) diminished levels of thyroid-binding globulin - Ans: A- high levels of circulating thyroid-stimulating immunoglobulins A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20, serum glucose 500 mg/dl, positive urine glucose and ketones, serum postassium (K+) 2 mEq/L, and serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the "flu" for a week. What relationship do these values have to his insulin deficiency? A) increased glucose use causes the shift of fluid from the intravascular to the intracellular space B) decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis C) increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis D) decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss - Ans: B- decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis Type 2 diabetes mellitus is best described as: A) resistance to insulin by insulin-sensitive tissues B) the needs for lispro intead of regular insulin C) an increase in glucagon secretion from (alpa) cells of the pancreas D) the presence of insulin autoantibodies that destroy (beta) cells in the pancreas - Ans: A- resistance to insulin by insulin-sensitive tissues common hay fever is expressed through a reaction that is mediated by which class of immunoglobulins? A) immunoglobulin E (IgE) B) immunoglobulin G (IgG) C) immunoglobulin M (IgM) D) T cells - Ans: A- immunoglobulin E (IgE) A person diagnosed with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The most probable cause of these symptoms is:
A) hyperglycemia caused by incorrect insulin administration B) the dawn phenomenon from eating a snack before bedtime C) hypoglycemia caused by increased exercise D) Somogyi effect from insulin sensitivity - Ans: C- hypoglycemia caused by increased exercise Hypoglycemia followed by rebound hyperglycemia, is observed in those with: A) the Somogyi effect B) the dawn phenomenon C) diabetic ketoacidosis D) hyperosmolar hyperglycemic nonketotic syndrome - Ans: A- the Somogyi effect Which structure is lined with columnar epithelial cells? A) perimetrium B) endocervical canal C) myometrium D) vagina - Ans: B- endocervical canal Where is the usual site of cervical dysplasia or cancer in situ? A) wher the squamos epithelium of the cervix meets the cuboidal epithelium of the vagina B) where the columnar epithelium fo the cervix meets the squamous epithelium of the uterus C) where the squamous epithelium of the cervix meets the columnar epithelium of the uterus D) where the columnar epithelium of the cervix meets the squamous epithelium of the vagina - Ans: D- where the columnar epithelium of the cervix meets the squamous epithelium of the vagina Which statement best describes a Schilling test? A) administration of radioactive cbalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency B) measurement of anigen-antibody immune complexes in the blood to test for hemolytic anemia C) measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia D) administration of folate and measurement in two hours of its level in a blood sample to test for folic acid deficiency - Ans: A- administration of radioactive cbalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency In aplastic anemis (AA), pancytopenia develops as a result of which of the following? A) suppression of erythropoietin to produce adequate amounts of erythrocytes B) suppression of the bone marrow to produce adequte amounts of erythrocytes, leukocytes, and thrombocytes
What factor associated with gluten-sensitive enteropathy (celiac sprue) causes an infant to bruise and bleed easily? A) vitamin K deficiency from fat malabsorption B) bone marrow function depression C) iron, folate, and B12 deficiency anemias D) prescrbed daily warfarin (Coumadin) - Ans: A- vitamin K deficiency from fat malabsorption
